Microbiological Evaluation of One- and Two-Visit Endodontic Treatment of Teeth with Apical Periodontitis: A Randomized, Clinical Trial
T. Kvist, DDS, PhD, A. Molander, DDS, PhD, G. Dahlén, DDS, PhD, and C. Reit, DDS, PhD
Lack of Genotoxicity of Formocresol, Paramonochlorophenol, and Calcium Hydroxide on Mammalian Cells by Comet Assay
Daniel Araki Ribeiro, DDS, MsD, Mariângela Esther Alencar Marques, PhD, and Daisy Maria Fávero Salvadori, PhD
Nerve Blocks in Patients with Irreversible Pulpitis
Elizabeth Claffey, DDS, MS, Al Reader, DDS, MS, John Nusstein, DDS, MS, Mike Beck, DDS, MA, and Joel Weaver, DDS, PhD
Effect of Solvents on Bonding to Root Canal Dentin
Ali Erdemir, DDS, PhD, Ayce Unverdi Eldeniz, DDS, PhD, Sema Belli, DDS, PhD, and David H. Pashley, DMD, PhD
Q-switched Versus Free-running Er:YAG Laser Efficacy on the Root Canal Walls of Human Teeth: A SEM Study
Marouan G. Khabbaz, Mersini I. Makropoulou, Alexandros A. Serafetinides, Dimitris Papadopoulos, and Eirini Papagiakoumou
Root Canal Treatment in a Population-Based Adult Sample: Status of Teeth After Endodontic Treatment
Ken R. Tilashalski, DMD, Gregg H. Gilbert, DDS, MBA, Michael J. Boykin, DMD, MS, and
Brent J. Shelton, PhD
Coronal Microleakage of Three Temporary Restorative Materials: An In Vitro Study
Osvaldo Zmener, DDS, Dr Odont, Gladys Banegas, DDS, and Cornelis H. Pameijer, DMD, MScD, DSc, PhD
Current Challenges and Concepts in the Preparation of Root Canal Systems: A Review
Ove A. Peters, PD Dr med dent, MS FICD
Nonsurgical Endodontic Treatment of Dens Invaginatus with Large Periradicular Lesion: A Case Report
Sheng-Fang Pai, DDS, Shue-Fen Yang, DDS, MS, and Louis M. Lin, BDS, DMD, PhD
Taurodontism in Six Molars: A Case Report
S. Sert, and G. Bayırlı
Microbiological Evaluation of One- and Two-Visit Endodontic Treatment of Teeth with Apical Periodontitis: A Randomized, Clinical Trial
T. Kvist, DDS, PhD, A. Molander, DDS, PhD, G. Dahlén, DDS, PhD, and C. Reit, DDS, PhD
The antimicrobial efficacy of endodontic procedures performed in one-visit (including a 10-min intraappointment dressing with 5% iodine-potassium-iodide) was compared with a two-visit procedure (including an interappointment dressing with calcium-hydroxide paste). Teeth with apical periodontitis (n = 96) were randomly assigned to either group. Root canal sampling and culturing were performed before and immediately after instrumentation, and after medication. Initial sampling demonstrated the presence of microorganisms in 98% of the teeth. Postinstrumentation sampling showed reduction of cultivable microbiota. Antibacterial dressing further reduced the number of teeth with surviving microbes. In the postmedication samples, residual microorganisms were recovered in 29% of the one-visit teeth and in 36% of the two-visit treated teeth. No statistically significant differences between the groups were discerned. It was concluded that from a microbiological point of view, treatment of teeth with apical periodontitis performed in two appointments was not more effective than the investigated one-visit procedure.
Lack of Genotoxicity of Formocresol, Paramonochlorophenol, and Calcium Hydroxide on Mammalian Cells by Comet Assay
Daniel Araki Ribeiro, DDS, MsD, Mariângela Esther Alencar Marques, PhD, and Daisy Maria Fávero Salvadori, PhD
Formocresol, paramonochlorophenol, and calcium hydroxide are widely used in dentistry because of their antibacterial activities in root canal disinfection. However, the results of genotoxicity studies using these materials are inconsistent in literature. The goal of this study was to examine the genotoxic potential of formocresol, paramonochlorophenol, and calcium hydroxide using mouse lymphoma cells and human fibroblasts cells in vitro by the comet assay. Data were assessed by Kruskal-Wallis nonparametric test. The results showed that all compounds tested did not cause DNA damage for the tail moment or tail intensity parameters. These findings suggest that formocresol, paramonochlorophenol, and calcium hydroxide do not promote DNA damage in mammalian cells and that the comet assay is a suitable tool to investigate genotoxicity.
Nerve Blocks in Patients with Irreversible Pulpitis
Elizabeth Claffey, DDS, MS, Al Reader, DDS, MS, John Nusstein, DDS, MS, Mike Beck, DDS, MA, and Joel Weaver, DDS, PhD
The purpose of this prospective, randomized, double-blind study was to compare the anesthetic efficacy of 4% articaine with 1:100,000 epinephrine to 2% lidocaine with 1:100,000 epinephrine for inferior alveolar nerve blocks in patients experiencing irreversible pulpitis in mandibular posterior teeth. Seventy-two emergency patients diagnosed with irreversible pulpitis of a mandibular posterior tooth randomly received, in a double-blind manner, 2.2 ml of 4% articaine with 1:100,000 epinephrine or 2.2 ml of 2% lidocaine with 1:100,000 epinephrine using a conventional inferior alveolar nerve block. Endodontic access was begun 15 min after solution deposition, and all patients were required to have profound lip numbness. Success was defined as none or mild pain (Visual Analogue Scale recordings) on endodontic access or initial instrumentation. The success rate for the inferior alveolar nerve block using articaine was 24% and for the lidocaine solution success was 23%. There was no significant difference (p _ 0.89) between the articaine and lidocaine solutions. Neither solution resulted in an acceptable rate of anesthetic success in patients with irreversible pulpitis.
Effect of Solvents on Bonding to Root Canal Dentin
Ali Erdemir, DDS, PhD, Ayce Unverdi Eldeniz, DDS, PhD, Sema Belli, DDS, PhD, and David H. Pashley, DMD, PhD
The long-term success of resin cementation of post/cores is likely increased with improvement in resin-root canal dentin bonding. The adverse effect of some irrigation constituents (NaOCl, H2O2) or medications (eugenol) on the bond strengths of resins to dentin have been reported. The purpose of this in vitro study was to evaluate the effect of two gutta-percha solvents (chloroform versus halothane) on microtensile bond strength to root canal dentin. Thirty, extracted, human, single-rooted teeth were instrumented to a #70 file and randomly divided into 3 groups of 10 each. The root canals were treated with water, chloroform, or halothane for 60 s. All root canals were obturated using C&B Metabond. After 24 h of storage in distilled water, serial 1-mm-thick cross-sections were cut and trimmed. Microtensile bond strength to apical, middle, and coronal root canal dentin were measured using an Instron machine. Using pooled data, the results indicated that water-treated roots had significantly higher resin-dentin bond strengths compared with chloroform or halothane treatment groups (control: 23.9 MPa; chloroform: 18.3 MPa; halothane: 17 MPa; p < 0.05). Gutta-percha solvents have an adverse effect on bond strengths of adhesive cements to root canal dentin.
Q-switched Versus Free-running Er:YAG Laser Efficacy on the Root Canal Walls of Human Teeth: A SEM Study
Marouan G. Khabbaz, Mersini I. Makropoulou, Alexandros A. Serafetinides, Dimitris Papadopoulos, and Eirini Papagiakoumou
Twenty-one teeth with one root canal were prepared by the step-back technique, divided into three groups, and split longitudinally. Group A served as a control. In group B, 20 to 150 pulses of 100 _s, 30 to 70 mJ per pulse at 1 to 4 Hz from a free-running Er:YAG laser were applied to the rootcanal dentin. In group C, the Q-switched Er:YAG laser, with the same energy parameters and a 190-ns pulse duration was used. Scanning electron microscopy examination revealed that control specimens had debris and smear layer obscuring the dentinal tubules at all levels in the canals without crack formation. Both groups of laser-treated dentin were clean with opened dentinal tubules except around the lased area in which there was an intact smear layer. Cracks were observed in both laser groups with higher frequency in group C. In group B, craters with different depth levels at the root canal walls were produced and the energy apparently was distributed equally, because craters were well-shaped. In contrast, the ablation efficiency in group C was questionable with the parameters used in this study. Consequently, suitable parameters of the free-running Er:YAG laser must be found before its careful use as an adjunct in endodontic therapy.
Root Canal Treatment in a Population-Based Adult Sample: Status of Teeth After Endodontic Treatment
Ken R. Tilashalski, DMD, Gregg H. Gilbert, DDS, MBA, Michael J. Boykin, DMD, MS, and
Brent J. Shelton, PhD
The purpose of this study was to quantify treatment outcomes of endodontically treated teeth, in a representative, population-based adult sample. The “Florida Dental Care Study” was a prospective, longitudinal, cohort study of 873 subjects who had at least one tooth at baseline and who were 45 yr or older. An in-person interview and clinical examination were conducted at baseline, 24 months, and 48 months after baseline, with 6-monthly telephone interviews between those times. Dental record information was abstracted afterward. Seventy-five teeth had conventional root-canal therapy (RCT) performed and met the inclusion criteria of 1-yr of follow-up or extraction. The mean duration of follow-up after RCT was 24.8 months. The mean (SD) attachment loss (AL) on teeth receiving RCT was only 3.3 (1.4) mm. Permanent restorations were placed in 79% of teeth a mean of 4.4 months after the RCT. However, 12% of teeth did not have any restorative treatment after RCT. After RCT had been completed, 81% of teeth were retained and 19% were ultimately extracted. Taken as a whole, this community-based study of a representative sample of adults suggests a higher failure rate than reported from studies in highly controlled environments or insured populations. It also suggests that the length of time to initial restoration of RCTtreated teeth is less than optimal. RCT was almost never performed on teeth with advanced periodontal attachment loss.
Coronal Microleakage of Three Temporary Restorative Materials: An In Vitro Study
Osvaldo Zmener, DDS, Dr Odont, Gladys Banegas, DDS, and Cornelis H. Pameijer, DMD, MScD, DSc, PhD
The sealing properties of three temporary restorative materials, Cavit, IRM, and a polycarboxylatebased cement, Ultratemp Firm, were investigated in vitro. Standardized access cavities were prepared in 45, intact, extracted, human molars. The teeth were randomly assigned to three groups and the access openings filled with one of three temporary filling materials. In five teeth (negative control), no restorative material was placed but the preparations were coated entirely with sticky wax. The five teeth of the positive control group had no restorative material and no sticky wax applied. After thermocycling for 500 cycles (5–55°C), the experimental teeth were dipped in molten sticky wax to the CEJ. The coronal enamel was subsequently coated with two layers of nail varnish, leaving an area of 1 mm around the filling material uncovered. The samples were then immersed in 2% methylene blue dye solution for leakage assessment. The teeth were sectioned and the greatest depth of dye penetration was recorded. Positive control sections exhibited complete dye penetration, whereas negative controls had none. There was no statistically significant difference in marginal leakage between Cavit, IRM, and Ultratemp Firm (p > 0.05). All materials leaked at the interface material-dentin, whereas some IRM specimens absorbed the dye into the bulk of the material.
Current Challenges and Concepts in the Preparation of Root Canal Systems: A Review
Ove A. Peters, PD Dr med dent, MS FICD
Nickel-titanium rotary instruments are important adjuncts in endodontic therapy. This review attempts to identify factors that influence shaping outcomes with these files, such as preoperative root-canal anatomy and instrument tip design. Other, less significant factors include operator experience, rotational speed, and specific instrument sequence. Implications of various working length definitions and desired apical widths are correlated with clinical results. Despite the existence of one ever-present risk factor, dental anatomy, shaping outcomes with nickel-titanium rotary instruments are mostly predictable. Current evidence indicates that wider apical preparations are feasible. Nickel-titanium rotary instruments require a preclinical training period to minimize separation risks and should be used to case-related working lengths and apical widths. However, and despite superior in vitro results, randomized, clinical trials are required to evaluate outcomes when using nickel-titanium instruments.
Nonsurgical Endodontic Treatment of Dens Invaginatus with Large Periradicular Lesion: A Case Report
Sheng-Fang Pai, DDS, Shue-Fen Yang, DDS, MS, and Louis M. Lin, BDS, DMD, PhD
The endodontic treatment of teeth with severe Type 3 dens invaginatus, characterized by an infolding of enamel and dentin, extending deep into the pulp cavity near the root apex, may be complicated and challenging. Because of the bizarre root canal anatomy and widely open apex, a combination of nonsurgical and surgical endodontic treatment or extraction is the most common choice of therapy. This article describes a nonsurgical endodontic treatment of a tooth with severe Type 3 dens invaginatus and an associated large periradicular lesion. After complete removal of the invaginated central mass of hard tissue and long-term calcium hydroxide treatment, nonsurgical endodontic treatment was performed. Complete healing of the periradicular lesion was observed at 25-month and 74-month follow-up examinations.
Taurodontism in Six Molars: A Case Report
S. Sert, and G. Bayırlı
This case report describes taurodontism in six molars of one patient. There were two mandibular second molars and four maxillary molars. All of them were hypertaurodont.